A pilot randomized controlled trial comparing McKenzie and stabilization exercises for non-specific neck pain in females aged 18–50 years: Effects on proprioception, pain, disability, and deep neck flexor endurance

Abstract

This pilot study compared the effects of McKenzie and cervical stabilization exercises on proprioception, pain, disability, and deep neck flexor endurance in females aged 18–50 years with non-specific neck pain (NSNP). In this single-blind, randomized controlled pilot trial, 40 females (18–50 years) with chronic NSNP were allocated to McKenzie (Group A, n = 20) or stabilization (Group B, n = 20). Outcomes were assessed pre/post-intervention using JPE, VAS, NPADS, and deep neck flexor endurance tests. Both groups received three sessions/week for 4 weeks. Between-group analyses used two-way mixed ANOVA; ANCOVA was used to adjust for baseline differences in VAS and left-rotation JPE. Effect sizes were reported as ηp² and Cohen's d. Although both interventions produced clinically significant within-group improvements across all measured outcomes, mixed ANOVA showed no significant Time × Group interactions for VAS, NPADS, endurance, or JPE flexion/extension/right rotation (all p > 0.05). A significant Time × Group interaction was initially observed for left-rotation JPE (F(1,38) = 7.486, p = 0.009, ηp² = 0.165). However, after adjustment for the baseline imbalance, ANCOVA showed no significant between-group difference in left-rotation JPE, indicating comparable efficacy between interventions. ANCOVA also confirmed no significant between-group difference in post-intervention VAS after baseline adjustment. All participants (100%) achieved the Minimal Clinically Important Difference (MCID) (≥2-point VAS reduction). In conclusion, both interventions are effective for NSNP, with comparable efficacy across most outcomes. After accounting for baseline differences, no significant between-group superiority was demonstrated, including for left-rotation proprioception.